According to a 2021 report by the Louisiana Center for Health Equity, there is a 20-year difference of life expectancy based on where you live in the state, your gender and race. Health care professionals, like Dr. Keith Winfrey of the NOELA Community Health Center in New Orleans East, say this disparity can be reduced with access to quality health care, including telehealth options, and life-saving health screenings.
Winfrey is the chief medical officer at NOELA. The health care center was created to provide access to quality health care to residents in New Orleans East, which has one of the city’s most diverse populations. NOELA is one of several health care providers that will be featured at the Hospitality Health Fair on Wednesday, Nov. 15 between 11 a.m.-5 p.m. at Champions Square. Verite is a media partner for the health fair.
A native of Atlanta, Winfrey moved to New Orleans in 1990 to attend Xavier University. He then went on to Tulane Medical School, where he graduated in 1998.
As chief medical officer at NOELA, Winfrey identifies trends and healthcare needs of the community served by the center. He also creates strategies and programs to help address those needs.
Winfrey talked to Verite about health disparities, the importance of health screenings and reaching underserved communities.
Verite: Why did you want to become a doctor?
Winfrey: For me, it was a combination of factors. The first was just a fascination over the human body, how it works and how to heal yourself from illness. My mother grew up in the South, in rural Alabama, and so she always had these home remedies for how to cure things. I wanted to learn how health and treatments worked. That was partnered with my desire to help others, particularly solve problems.
I think the third and most important was just being intrigued by the disparity of healthcare, particularly in the African American community. Even back in the 80s when I was in high school, just learning about the different mortality rates between African Americans and others, and rates of diabetes and cancer and heart disease — how it was always so much higher in our population than others.
How do we address that and why hasn’t anyone addressed it already? I grew up in Atlanta, home of the CDC [Centers for Disease Control and Prevention]. They have all those population data and statistics. It was just intriguing to me — if you have the data and statistics, why hasn’t that problem been solved? Those combinations of factors led me to healthcare.
Verite: In your role as a medical provider, as a healthcare professional, why do you think health disparities still exist despite everything that we know now about medicine and health and all the technological advancements that we have?
Winfrey: That’s the age-old question. There are a lot of variables that affect these disparities. They can be from poverty to socioeconomic status, education, access to healthcare, income, housing stability. There’s a number of factors that go into play that together cause these populations to have worse outcomes. It’s a combination of factors. Physicians like myself, we are here to try to address these areas as best we can. We tend to focus more on the areas that we have influence over, which is access to care, access to medications, access to screenings, early detection. We try to solve those factors, but oftentimes we’ll have to partner up with other social services agencies to address those areas outside of healthcare, but that can actually influence one’s health.
Verite: How long have you been at NOELA?
Winfrey: I’ve been at NOELA since 2009. A little history behind NOELA. NOELA was initially started by Tulane University School of Medicine. It was started right after Katrina in response to the community’s request for access to quality healthcare in their community. As a result of that request, Tulane partnered with Children’s Hospital to open up both an adult clinic and a pediatric clinic. When I returned to New Orleans from Katrina, I was on faculty at Tulane. That’s how I got assigned to this particular clinic.
Verite: Let’s talk about the importance of health screenings. How important are they?
Winfrey: Health screenings for us are essential. They are paramount. A large part of the health disparities come from being diagnosed with these conditions — cancers, diabetes, hypertension, heart disease — at a later stage.
African Americans tend to be at a higher risk for these conditions due to sometimes lack of healthcare-seeking behaviors or just not getting screened earlier. By the time patients actually begin to have symptoms, the conditions have already advanced to the point where they require intensive therapy and resources, which sometimes are not available to our patients. Screenings allow us to identify either risk factors or the conditions at a much earlier stage when the right interventions, preventive measures, lifestyle changes can really change the course or direction of that condition.
At NOELA, this is how we are working to correct those disparities. This is how we are working to improve health outcomes, by starting at the screening and prevention level. A lot of that requires educating our patients on why they should get screened. If something is detected early, the chances of you either getting cured or having a better outcome through treatment is so much higher and the mortality rate is much lower.
Verite: What have you seen as some of the biggest obstacles to getting access to quality healthcare?
Winfrey: I think awareness, meaning knowing where to look for these primary care providers. Here in New Orleans it’s 504healthnet.org. It’s a great resource that helps point residents to safety net clinics throughout the city that will provide care to you regardless of your income and insurance status.
If you’re uninsured, if you’re underinsured, if you have commercial insurance, Medicare, Medicaid, it doesn’t matter. 504HealthNet has a list of facilities throughout the Greater New Orleans area that will be able to provide care for you. Outside of New Orleans, LPCA, Louisiana Primary Care Association, also has a list of the safety net facilities. These primary care practices throughout the state are also designed to take care of individuals regardless of their insurance status and their income level.
Some places provide transportation assistance. Others, once you get established, tend to offer telehealth services, so that you don’t have to go to the clinic every time. Maybe for the first visit or two, you go in person, and then you have the option to do a few telehealth visits. Then for the community that we serve, just knowing where primary care providers exist that understand your culture and speak your language.
Verite: As a doctor who serves minority and low-income communities, what has surprised you the most about our healthcare system?
Winfrey: To me, not having more diversity in the healthcare space. I don’t know if it’s more of a disappointment than a surprise, of the lack of racial concordance in healthcare, meaning just having more healthcare providers that look like the patient that they serve. There’s evidence that shows that where there’s racial concordance between the healthcare provider and the patient trust is built. Patients are more likely to follow through on recommendations. They tend to have a more equitable distribution of healthcare, like receiving the screening tests or other procedures that are necessary. We are seeing more diversity, more gender diversity, more racial diversity. That’s an encouraging sign. But just recognizing that as diverse as our city, state, and country is becoming, that’s how much more diverse our healthcare service needs to be.
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